Hormone receptor status, tumor characteristics, and prognosis: a prospective cohort of breast cancer patients

Abstract

BackgroundBreast cancer patients with tumors that are estrogen receptor (ER)-positive and/or progesterone receptor (PR)-positive have lower risks of mortality after their diagnosis compared to women with ER- and/or PR-negative disease. However, few studies have evaluated variations in the risks of breast cancer-specific mortality across ER/PR status by either demographic or clinical characteristics.MethodsUsing data from 11 population-based cancer registries that participate in the SEER (Surveillance, Epidemiology, and End Results) program, 155,175 women at least 30 years old with a primary diagnosis of invasive breast carcinoma from 1990 to 2001 were included in the study. Associations between joint hormone receptor status and breast cancer mortality risk within categories of diagnosis age, diagnosis year, race/ethnicity, histologic tumor type, stage, grade, size, and axillary lymph node status were evaluated using the Cox proportional hazards model.ResultsCompared to ER+/PR+ cases, elevations in risk of mortality were observed across all subcategories of age at diagnosis, ranging from 1.2- to 1.5-fold differences for ER+/PR- cases, 1.5- to 2.1-fold differences for ER-/PR+ cases, and 2.1- to 2.6-fold differences for ER-/PR- cases. Greater differences were observed in analyses stratified by grade; among women with low-grade lesions, ER-/PR- patients had a 2.6-fold (95% confidence interval [CI] 1.7 to 3.9) to 3.1-fold (95% CI 2.8 to 3.4) increased risk of mortality compared to ER+/PR+ patients, but among women with high-grade lesions, they had a 2.1-fold (95% CI 1.9 to 2.2) to 2.3-fold (95% CI 1.8 to 2.8) increased risk.ConclusionCompared to women with ER+/PR+ tumors, women with ER+/PR-, ER-/PR+, or ER-/PR- tumors experienced higher risks of mortality, which were largely independent of the various demographic and clinical tumor characteristics assessed in this study. The higher relative mortality risks identified among ER-/PR- patients with small or low-grade tumors raise the question of whether there may be a beneficial role for adjuvant chemotherapy in this population.

Receipt of adjuvant systemic therapy among patients with high-risk breast cancer detected by mammography screening

“…This is especially true for ER/PgR data. The cancer registries that participate in the Surveillance, Epidemiology, and End Results programme of the U.S. National Cancer Institute began collecting data on ER/PgR status of breast cancer in 1990, and only in 2001 did the proportion of cases with no recorded information decrease to less than 20% [25]. The result obtained for the present study, 24% of cases in the final analysis, is acceptable.…”

Relationship between Preoperative Serum CA15-3 and CEA Levels and Clinicopathological Parameters in Breast Cancer

“…It has been shown that different hormone receptor status could have an effect on the level of breast cancer patient's mortality (Dunnwald et al, 2007). We found majority of patients, 63% were hormone receptor positive (ER/PR+) and only 6.6% were identified as triple negative.…”

Estrogen receptor (ER) mRNA expression and molecular subtype distribution in ER-negative/progesterone receptor-positive breast cancers

“…[12] Because it represents a rare receptor subtype, it is unlikely that a prospective clinical trial would ever be conducted to define the optimal adjuvant treatment strategy for this disease. ER negative/PR positive status may arise from testing artifacts, including false positive IHC results in a truly HR negative tumor [20] …”

“…[12] Some data suggests that cancers may not significantly benefit from adjuvant endocrine therapy. [1].…”